title: Proximal opening-wedge osteotomy of the first metatarsal for moderate and severe hallux valgus using low profile plates.
abstract: BACKGROUND
  To present the results of the treatment of hallux valgus with the proximal metatarsal opening wedge (PMOW) osteotomy using two different screw and plate systems.
  
  
  METHODS
  Forty-one patients with moderate and severe hallux valgus were treated with the PMOW osteotomy between 2005 and 2009. The fixation was obtained by the Darco(®) BOW or by the Arthrex(®) LPS plate. Biplanar chevron and/or Akin osteotomy were associated according to the magnitude of distal angles. Each patient was evaluated with weight-bearing radiographs and AOFAS score.
  
  
  RESULTS
  The HV, IM, DMA and IP angles improved by a mean of 14°, 8°, 11°, 7° respectively. The sesamoid position improved in 79% of the feet. AOFAS score improved from a mean of 50 to 82.
  
  
  CONCLUSIONS
  The PMOW osteotomy is effective to correct high-level hallux valgus deformities. Both systems guarantee the stability and correction of the osteotomy site. The combination with distal procedures is advisable to correct distal angles.
authors.affiliation: Foot and Ankle Clinic, UNIFESP-Escola Paulista de Medicina, São Paulo, SP, Brazil. Electronic address: caionerymd@gmail.com.
authors.forename: Caio
authors.initials: C
authors.lastname: Nery
authors.forename: Cibele
authors.initials: C
authors.lastname: Réssio
authors.forename: Gerson
authors.initials: G
authors.lastname: de Azevedo Santa Cruz
authors.forename: Rafael Silva Remor
authors.initials: RS
authors.lastname: de Oliveira
authors.forename: Carla
authors.initials: C
authors.lastname: Chertman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods*; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D012716:Sesamoid Bones / Q000000981:diagnostic imaging; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Basilar osteotomy/methods; Hallux valgus/surgery; Low profile plates/methods; Orthopedic procedures/methods